Use of extracellular matrix biomarkers in clinical research

In pathological conditions involving alterations in the activity of extracellular matrix (ECM)-targeted proteases, the product of protease activity on the surrounding tissue yields ECM fragments specific for the pathological process. Fragments of ECM components are suitable for use as biomarkers in several disease areas characterized by abnormal ECM turnover. In bone diseases, early changes in fragments of cross-linked collagen type I (CTX-I) are a standard surrogate marker of clinical benefit, while other ECM markers are being investigated as diagnostic, predictive, and prognostic markers in other disease areas; they are particularly promising in respiratory, hepatic, and arthritic conditions. ECM biomarkers can also be used to monitor tissue turnover in translational research of potential drug candidates using ex vivo tissue explants.